Triple threat to health

Older African American women who have experienced high levels of family violence throughout their lives are more likely to suffer worse physical and mental health than their counterparts, according to a new report by a Temple researcher published in the February issue of the Journal of Women’s Health.

“In general, there is a higher incidence of mental health issues such as depression and anxiety, and more chronic pain syndromes,” said lead author Anuradha Paranjape, M.D., M.P.H., an associate professor of medicine at Temple University School of Medicine and Hospital.

Photo by Kelly & Massa

Paranjape

“I think this is an issue for all older women. I have focused on African American women because of my experiences as a busy clinician in downtown Atlanta and now at Temple, where most of my patients are African American. This is an underserved community that experiences health disparities,” Paranjape said.

National data shows older African American women are at risk for experiencing poorer health status by virtue of their age, race and gender. Given this triple threat to their overall health, examining the effect of family violence in this demographic group is particularly important, Paranjape noted. These older women have unique service needs since their history of abuse can span the spectrum of intimate partner violence to other types of abuse later in life.

“Clinicians caring for older African American women need to be cognizant of the role both current and prior violence exposure may play in their patients’ current health status,” Paranjape said.

Paranjape advises primary care physicians “to empathize and validate the patient’s experiences, and refer them to social support organizations if needed.” More importantly, physicians need to know that there may be non-medical reasons why a patient doesn’t feel well. In Pennsylvania, it’s mandatory for heathcare providers to report suspected abuse in patients over 60.

For the study, 158 African American women age 50 or older were interviewed in ambulatory clinics of a large public hospital. Study participants were asked about the presence and severity of physical violence, emotional, financial, and sexual abuse, neglect, and coercion. Researchers used this information to measure and analyze patterns of lifetime family violence exposure as well as an adult physical and mental health status.

The results showed significant differences in health for women who had reported high levels of family violence compared to those who reported low levels or no history of abuse. Unemployment was also found to be strongly associated with worse health status, Paranjape said.

“The next step is to look at what differentiates the women who do better from those who do worse. It is possible that women who do better have better coping skills. In that case, programs that are designed to help survivors of abuse cope in a healthy way need to be funded, implemented and assessed for efficacy,” she said.

—Written by Anna Nguyen

The study was funded by a grant to Anuradha Paranjape through the Emory Mentored Clinical Research Scholars Program from the National Institutes of Health. Other authors are: Nancy E Sprauve-Holmes, M.P.H., research consultant, Savannah, Georgia; John Gaughan, Ph.D., Biostatistics Consulting Center, Temple University School of Medicine, Philadelphia, Pennsylvania; and Nadine J. Kaslow, Ph.D., Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia.